Page 27 - Andy Goetz Proposal

AMERICAN HERITAGE LIFE INSURANCE COMPANY

SUMMARY and DISCLOSURE STATEMENT for
ACCELERATED DEATH BENEFIT FOR TERMINAL ILLNESS OR CONDITION RIDER

Provides for the acceleration of a portion of the death benefit due to a terminal illness or condition.
The benefit received under the rider may be taxable.
The certificate holder should consult with his or her personal tax advisor.

Benefit Description
If the insured has a terminal illness or condition while the rider is in force, we will pay the accelerated death benefit in a lump
sum to the certificate holder upon our receipt of:
1. the certificate holder’s written request for the accelerated death benefit;
2. written certification from a physician that the insured has a terminal illness or condition; and
3. signed consent from any irrevocable beneficiary or assignee.

A terminal illness or condition means an illness or physical condition: (1) for which there is no reasonable prospect of
recovery; and (2) that is expected to result in the insured’s death within 24 months.

The accelerated death benefit under the rider can only be elected once, per certificate.

Rider Benefit Amount
The accelerated death benefit is equal to 75% multiplied by the certificate death benefit amount, up to a maximum amount
of $100,000.

The accelerated death benefit does not include the amount of any Accidental Death Benefit or any Term Rider(s).

The accelerated death benefit payable is equal to:
1. the accelerated death benefit discounted at the current discount rate; less
2. any pro rata certificate debt; less
3. any due and unpaid premium.

Discounting will be done using simple interest and the expected lifetime of the insured.

Premiums
There is no separate premium for the rider.

Impact of an Accelerated Death Benefit for Terminal Illness or Condition
After we pay the accelerated death benefit, the certificate death benefit, cash value, and any certificate debt will be reduced
accordingly on a pro rata basis.

We will waive premiums for a certificate and any attached rider(s) if the accelerated death benefit is paid. This waiver of
premium is in lieu of any other premium waiver benefit provided by a certificate or any attached rider(s).

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